Fatal left ventricular perforation during mitral balloon valvoplasty

Abstract Percutaneous balloon dilation of left-sided cardiac valves is being performed with increasing frequency. We describe and document the mechanism of injury of left ventricular perforation during mitral balloon valvoplasty. Despite a technically successful surgical repair with hemodynamic restoration, the patient was brain dead. We emphasize (1) the risk and the potentially catastrophic nature of left ventricular perforation during mitral balloon valvoplasty and (2) the need for surgical standby and rapid operative decompression for this complication.